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amie sign-up form

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Mail it to the following address with your check or money order for $7.00
($13.00 for international addresses)
made payable to amie.

amie
370 S. Lowe Ave, Suite A
PMB 211
Cookeville, TN 38501

Name ________________________________________________

Address _____________________________________________

_____________________________________________________

Age (optional) ___________

E-mail address (if available) _____________________________________________

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